Everybody Hurts: Understanding Dukkha in Buddhism


The root of suffering (Dukkha) is attachment ~ Shakyamuni Buddha

If there is one word in the Buddhist world that causes so much confusion, and conflict, it is the word “Dukkha” (Pali) or “Duḥkha” (Sanskrit).  For simplicity, I will just use the Pali version of Dukkha in this article.

Popularly translated as “suffering” for the masses, and in more modern translations referred to as “unsatisfactoriness”, the actual meaning is much more complex.  Yet understanding Dukkha is extremely important.

Just glossing over Dukkha and calling it “suffering” to make our lives easier as Buddhists will not do anyone any favors.  After all, the whole purpose of Buddhism is to tackle this one single thing!  If we can’t understand Dukkha or don’t really care about it, then we are missing a crucial part of Buddhism.

Whenever I think of Dukkha, I can’t stop but remember the song by R.E.M. called “Everybody Hurts”.  The music video is perfect because you see what everyone is “thinking” and how they are experiencing Dukkha in their own lives.  In the end, they are all (dare I say it) enlightened by the group R.E.M. to get out of their cars, and leave (towards Nirvana?  No, that’s another music group and I don’t think R.E.M. would do that! 😉 ).  Before we start this article, take a moment to relax and watch the video:

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This article is part of a series on the basics of Buddhism.  Click here to view more.

Article Summary (TL;DR)

I know you may not have a lot of time to read a lengthy article (“too long; didn’t read”), so this summary can help.  However, it is best to read the entire article when you can!

The Four Noble Truths in Buddhism are all about overcoming this ‘affliction’ or ‘sickness’ of “Dukkha” in our lives through wisdom, conduct, and discipline.  But what is “Dukkha”?  It is important to understand this word and concept since it is central to why we practice Buddhism.

  1. Dukkha has no perfect ‘English’ translation.
    • Dukkha has been commonly translated as “Suffering” or “Unsatisfactoriness”.
    • Some prefer to keep the word untranslated, however, this can often be a barrier to people in exploring Buddhism.
    • “Du” is a prefix for “bad” or “difficult” and “kha” is the root meaning something like “axle hole” (like in a wheel).  The common analogy is that of a potter’s wheel, where the axle hole is not right and results in an unsatisfactory experience and creation.  An analogy of a wheel also works well, where the wheel is not made correctly (the axle hole is uneven, broken, etc.) so the ride (your life) is not satisfactory (“bumpy”).
    • In comparison “Sukha” is the opposite of Dukkha and refers to “good”.  This would be like a good axle hole/wheel that provides a smooth and satisfactory “ride” despite all the “bumps” in the road.
    • Dukkha has “internal” (physical and/or mental) and “external” (things that are outside our control) origins and results depending on the experience.
  2. Dukkha is a result of our attachments, specifically to the idea of “self”, and our inability to utterly understand that connection at a fundamental level.  
    • Due to delusion, we  believe in the illusion of “self”.  We believe we are permanent and independent.  Buddhism teaches that all conditioned things are impermanent and dependent on other things to be born and die.
    • Attachment to the self is the root source of all delusion. 
    • Attachments result in us craving things to protect the “self”.
    • Dukkha, which is the “sickness” we face, comes out of this craving to attachments.
    • This sickness, due to attachments, results in rebirth.
    • Attachments crave (desire, thirst, etc.) “fuel”, which they find with the “Three Poisons[/Fires]” (Ignorance/Delusions, Greed/Desire, and Anger/Hatred).  These are essentially ‘wrong views’ which cause us to have craving, which in turn cause us to be “attached” to samsara (our world/cycle of birth and death).
    • The good news is that following the Noble Eightfold Path, which is likened to a “prescription” the Buddha wrote, so all sentient beings (like you and me) so we can heal our sickness (“Dukkha”) caused by our delusions, desires, and attachments.  Following this path is known as the “Middle Way”, which means to not go to extremes in order to achieve enlightenment and Nirvana (which is our “natural” state, which is free of delusions, desires, and attachments).

Now that you have this summary, this article will provide you more information (hyperlinks on this page take you to other articles that I wrote which explain a topic further).

What is there Dukkha?

The Buddha explained why we have Dukkha in our life:

  1. All things are impermanent and dependent on causes and conditions to be born and die

  2. Due to delusion we believe in the illusion of “Self” (Anātman) thinking our body makes us permanent and independent
  3. This belief causes us to be attached (Upādāna) to things
  4. Which results in craving (Trishna/Taṇhā) that creates actions (Karma), keeping us trapped in a cycle of rebirth (Saṃsāra)


“Now this, monks, is the Noble Truth of dukkha: Birth is dukkha, aging is dukkha, death is dukkha; sorrow, lamentation, pain, grief, & despair are dukkha; association with the unbeloved is dukkha; separation from the loved is dukkha; not getting what is wanted is dukkha. In short, the five clinging-aggregates are dukkha.”  – Shakyamuni Buddha (SN 56.11)

First, let’s get it clear that an accurate translation of “Dukkha” in English is very difficult.  While this section may be lengthy (and cause you some Dukkha!), hopefully it can help explain this word a little better.

The etymology of “Dukkha”, a Pali word, consists of two parts:

  • Du:  This is the prefix and means “bad” or “difficult”.  Yet this is also where suffering or unsatisfactoriness comes in.  It refers to something “not being quite right”.
  • Kha:  This is the root of the word, and means “axle hole” (just like in a wheel) and/or “empty”.  In the time of the Buddha, dukkha could refer to a potters wheel that, if not turning smoothly, would be unsatisfactory (you can see how this relates to “Du” above).  So Dukkha would mean a wheel that was not working well.  The opposite of this is Sukha (“happiness”) where the wheel turned smoothly and correctly (the prefix “Su” means “good”).  Dukkha and Sukha are also part of the “Six Realms” in Buddhism.

With just that above example, we can understand why Dukkha worked so well for the Buddha’s teachings.  Our lives can be seen in the context of a wheel, that if the axle where the wheel is not turning smoothly, we are going to have a bumpy ride.  However, the opposite is a smooth ride!  (which reminds me of the funny scene in Harry Potter and the Prisoner of Azkaban!)

This is also a reason that the Dharma Wheel, which is a well-recognized symbol of Buddhism as an expression of the Noble Eightfold Path, so fits perfectly with the teachings on Dukkha.

When this “wheel” is perfect in our lives, it is “turning” smoothly (Sukha) so Dukkha does not affect us!  Now that’s what I call a smooth ride despite the bumps in the road!

And that is also another important piece:  life still happens.  The Buddha experienced aches and pains, loss of family members, discomfort, and even death.  All “bumps” in the road.  Yet his wheel always turned smoothly because he was enlightened to what Dukkha was all about and was able to remain in the state of Nirvana.  Isn’t that something practical and what we would want in our everyday lives?  Absolutely!

Despite this basic breakdown of the word, saying “Dukkha” is still a foreign sounding word to many people’s ears (since it is Pali, a language that only those deeply interested in Buddhist studies and translations would know), and would be hard for people to understand.  This is why “suffering” has taken such a strong foothold in the ‘translation’ of Dukkha (and that is OK, which I will explain in the last part of this article).

  • In essence, Dukkha refers to a state of unsatisfactoriness, disease, distress, despair, uncertainty, or even something similar to “not being quite right”.  This really is Dukkha more than “suffering” (although that can certainly be something you encounter with it).  There are so many definitions and examples of Dukkha, it would take a paragraph of explanation.
    • When we think of the word “suffering”, we often think “I must really not like what is going on!”  So if you are happy, in love, joyful, you may think that is not suffering (“dukkha”), but it actually still is Dukkha!  How so?  Because it is conditioned, transient (impermanent), and often filled with attachment.  For instance, you are in love until that loved one leaves you, goes to work, dies, gets sick, has a fight with them, etc.
    • This is sometimes why Buddhism is (wrongly) referred to as a pessimistic religion by those thinking our fixation with Dukkha, as “suffering”, means we like to suffer!  Not so!  But if we say that even love is suffering, then what is the opposite?
  • When we realize that attachments cause suffering, that our “self” (ego/five aggregates) causes suffering, and that our perceptions cause suffering, can we then learn how to really live?  For example, true love is not formed by attachments, and understanding that being happy (often through attachments) is impermanent and not true happiness.  Buddhism actually teaches that when we overcome attachments (which are fueled by the Three Poisons/Fires) we can truly be authentically ‘happy’, in ‘love’, etc.  This is when we realize our true state, known as Nirvana, that is beyond attachments.   It goes beyond our western definitions to something that is a liberation from attachments, to truly understanding how we are all interconnected, impermanent, and conditioned.  This awakening allows us to see the world as it truly is, and in turn, be liberated to be a free person within it.
    • In Buddhism, we call this liberation from attachments “Nirvana when we escape the fires of greed, hatred, and ignorance.  Nirvana is our natural state, and when we finally discover (or uncover) our original state it allows us to realize what ‘true’ happiness and life really is!  Dukkha still exists, and you are still in this world, but you no longer have attachments to things which is the key difference.

For a movie reference, imagine you are Arnold Schwarzenegger playing the “good” Terminator in the movie Terminator 2.  The bullets (imagine those bullets being “attachments” to things) being fired at him just ‘bounce’ off (since, well, he is an almost unstoppable cyborg) and he continues unaffected in his life and mission.  That’s you (minus the guns and being a cyborg) who are unaffected by attachments and the Dukkha that results.

But why does this matter?  What if you are really rich, have a great life, and only ‘occasionally’ have a bad day, etc?  This is because everyone has dissatisfaction no matter how wealthy or removed from the ‘daily grind’ they may be.  For example, even a rich person fears losing what they gained…such as their wealth, safety, and lifestyle.

  • I am often reminded of an explanation by scientists who say that a frog that is thrown into a pot of boiling water while try to jump right out (and so would we!).  But a frog that is in a pot of chilly water, which is slowly brought up to boiling, will be boiled alive without even realizing it.  We are that frog.  Sometimes life is like being thrown into boiling water, but often the water is just slowly being turned up on us that we don’t notice.
  • The result to all of this is rebirth.  Because we are consumed with attachments (fueled by the three poisons/fires), we are affected by Dukkha.  This obsession with attachments in turn keeps us endlessly consumed in the cycle of rebirth (which is our world of “samsara”).  The Buddha, realizing this, was able to find the “way out” of that self-imposed prison, while still living in our world.  He still suffered, and died, in our world.  Yet he was not affected anymore by it.  He did not generate the karma that results in rebirth and was able to enter the state of parinirvana (release from rebirth, karma, and our world of samsara) and at his death.

Therefore Dukkha is so hard to explain because it is a fluid, ever changing concept that depends on the circumstances at that particular moment.

All you need to know that while the word “suffering” is often used in place of Dukkha for a modern translation, that Dukkha can be like a smoldering flame…it doesn’t need to burn you in order to still be unsatisfactory. 

A Buddhist’s goal is to conquer how Dukkha affects them, so they can live in the peaceful state of Nirvana.

The Buddha’s Experience with Dukkha

If we pull back from even trying to translate Dukkha for a moment, we need to view the Buddha’s life before he was the Buddha.  He was a prince who was shielded from the realities of the world.

Even though he was in an ‘artificial’ reality created by his father, the king, he did experience Dukkha without understanding it.  It was only until he was able to sneak out of the palace with his attendant on four occasions (referred to by Buddhists as the “Four Sights“) which helped shock him into the reality of Dukkha.

The “four sights” of Prince Siddhartha which revealed the truth of the world, and prompted him to take the difficult step to leaving his life of luxury to discover the truth.

While he understood he needed to act, which meant leaving the catered and secure life of royalty for that of a homeless monk, he still did not have a clear understanding of Dukkha.  He practiced with different teachers, tried every technique out there, until the point he was barely eating and almost died while trying to bathe in a river.  If you ever see a statue or a picture of the Buddha where he looks like a skeleton, this is an example of the final extreme he encountered.

This wasn’t a good look for him. Photo by Kentie Heng on Flickr

This is when, after his strength was brought back to life thanks to a young girl who gave him milk, he vowed to meditate until he discovered the truth.  This is the truth we now know in the Four Noble Truths, which is about Dukkha, and the way to conquer Dukkha through the Noble Eightfold Path.

Digging into Dukkha

“Bhikkhus, it is through not realizing, through not penetrating the Four Noble Truths that this long course of birth and death has been passed through and undergone by me as well as by you. What are these four? They are the noble truth of dukkha; the noble truth of the origin of dukkha; the noble truth of the cessation of dukkha; and the noble truth of the way to the cessation of dukkha. But now, bhikkhus, that these have been realized and penetrated, cut off is the craving for existence, destroyed is that which leads to renewed becoming, and there is no fresh becoming.”  – Shakyamuni Buddha (DN 16 with dukkha left untranslated)

Right after the Buddha’s enlightenment, he proclaimed his Four Noble Truths, which are the cornerstone of Buddhist teachings.  Everything derives from these truths, which are the truths about Dukkha, and how to transcend it.

The Four Noble Truths are:

  1. The Truth of Suffering (“The Symptom”):  Life entails suffering (“Dukkha”)
  2. The Cause of Suffering (“The Diagnosis”):  This suffering is caused by craving or desire (“Trishna”)
  3. The Truth of the End of Suffering (“The Prognosis”):  There is a cure to this suffering, which helps you achieve a state known as “Nirvana
  4. The Truth of the Path That Frees of Suffering (“The Prescription”):  Follow the eightfold path to eliminate suffering in your life (“Maggha”)

While we may have learned a basic understanding in the section above about Dukkha, let’s go more into it and explain how Dukkha is actually “formed”:

  • There are two kinds of Dukkha (“suffering”) which are either internal or external.
    • Internal (mental) Dukkha occurs when we think something is part of “us”.  For example, fear, anxiety, being worried, frustration, anger, suspicion, etc.
    • External (physical) Dukkha is, as it sounds, something that comes from the “outside” of us.  For example, a natural or manmade disaster, war, violence by a criminal, being attacked, etc.
  • There are also three kinds of Dukkha which relate to the “quality” rather than the origin, as explained before.  To give you a fun example, here is my daily experience with dukkha: I experience the dukkha of loss and impermanence as I eat some chocolate, only to know the experience quickly fades away.  The taste, joy, sensation, and experience are wonderful in the moment, but it quickly ends as an aftertaste then to just a memory.  I experienced the Dukkha of loss (it no longer exists, because I ate it) and the Dukkha of impermanence (I don’t want the experience to end, but the chocolate is not permanent especially when it enters my mouth!).  And if I am unlucky, I experience Dukkha within dukkha as I get a tummy ache from eating too much chocolate. 
    • Dukkha of painful experiences [suffering] (“Dukkha-dukkha”):  Just by being alive, you are going to have Dukkha.  So many things can cause dissatisfaction/suffering such as freezing air without warmth, physical labor, getting a disease such as cancer, etc.  In the most basic of terms, this is what we typically think of with Dukkha because it causes suffering or pain at the physical/body or mind/emotional level.  Your birth, death, getting sick, arthritis, broken bones, headache, getting old, not getting what you want, distress, etc., are all “dukkha-dukkha”.
    • Dukkha of conditioned states [loss] (Samkhara-dukkha):  What happens when you lose something, or the excitement of an experience fades?  Dukkha.  Typically, the passage of time makes this happen, and what we are most familiar with this type of dukkha.  As we all know, nothing is permanent, yet we want it to be.  Buddhism teaches us that everything is conditioned (“Dependent Origination”), meaning that one thing is not independent of another (often referred to as “interconnected”).  For a basic example, you exist because the conditions are right for you to exist.  Originally, this is because your mother and father “made” you.  Yet you can also easily cease to exist.  This could be as simple as a lack of air, water, or food, which causes your conditions to ‘end’. You are only here because of causes and conditions.  When a loved one dies (perhaps from a medical condition), this is would be an example of this type of dukkha.  Dependent origination is a fundamental teaching of the Buddha that basically says, “nothing is permanent”, yet we don’t want to believe or accept it no matter how ‘true’ it is.  He said:
      When this is, that is.
      This arising, that arises.
      When this is not, that is not.
      This ceasing, that ceases.
    • Dukka of impermanence [change] (Viparinama-dukkha):  This is important.  If something is not permanent (such as yourself or a loved one, or even something like a flower that will eventually wither and die), that can (and often does) cause dukkha.  Since we cannot control our world (no matter how much we think we can), everything is always changing and that causes us uncertainty and grief!  This causes (as you can expect) a range of emotions (and at different levels) which may include fear or anxiety.  Knowing a loved one will die soon (due to a medical condition) is huge.
  • Finally, there are eight kinds of Dukkha and are grouped by their content.  Think of this as more of a detailed explanation for Dukkha.
    • Birth:  We experience the pain and fear that results from birth into a world where we are like a prisoner.  Our body cannot escape the physical nature of the world, and we must navigate it starting off as a helpless baby.
    • Old Age:  Even in the womb we are aging (even though we traditionally consider birth to be the start), and as we get older our abilities (both physical and mental) start to decline.
    • Illness:  I don’t know of anyone who has never had an illness (no matter how small), and we must all suffer through it.  Everything from aches and pains, indigestion, to outright disease, comes into play here.
    • Death:  All humans face the fate of death, and it will happen.  It can be quick, or slow, and painful or not painful.  Either way, we cannot escape this form of Dukkha.
    • Separation from loved ones:  Due to our desire for attachments, this affects us the most.  When someone dies, moves away, or even does not love us as we love them, it causes us this form of suffering.
    • Closeness to loathsome people:  We all have people we would rather not interact with!  Whenever we do have to interact, we suffer.
    • Not getting what we want:  Guess what?  We have become a more “attached” world, and not in a good way.  We have become more determined to possess things we want…and there sure seems to be a lot we want to have.  When we can’t get what we want, we suffer.
    • Five Aggregates:  This is a big one since it encompasses you!  So, yes, being “you” is Dukkha 😉  The Five Aggregates are what makes you ‘exist’ which are form, feeling, perceptions, mental formations, and consciousness.  You are alive because all five of these things exist.  Take any away, you cease to exist.  But when they are together, they cause something big:  fuel for dukkha.  Now that you are “you”, you want things (attachment)!  This is why the Buddha said “all things are on fire” because we see so many things that we are attached to, which fuel the cycle of rebirth.

Conquering Dukkha

“Both formerly & now, it is only dukkha that I describe, and the cessation of dukkha.”  – Shakyamuni Buddha (SN 22.86)

OK, so by now you are suffering from all this talk about Dukkha, and ready to take the next step.  Nirvana sounds great, and you want to achieve it.  What do you do?

  • The Buddha’s entire teachings are about how to stop attachments, so Dukkha won’t take a principal place in our life.   Although we shouldn’t think that all he cared about was “suffering”.  His goal was to help us free ourselves from our self-imposed prison, and live life as it truly should be lived (Nirvana), which allows us to end the cycle of birth and death (rebirth).  If we want to talk about happiness, that is it…the peaceful state of Nirvana was his true message, but he had to tackle its arch nemesis….Dukkha.  Therefore (in Mahayana) we include Nirvana in the Three Dharma Seals.
  • To help us end our addiction with “self”, which results in Dukkha, the Buddha explained the “middle way” (not going to extremes) which was the Noble Eightfold Path.  When fully understood and practiced as part of our daily life, we are truly walking in the path that gets us to realize Nirvana.  Yet as simple as the Eightfold Path appears, it can be exceedingly difficult to truly understand and practice.  Additionally, different Buddhist schools and practices have separate ways to “achieve” the cessation of Dukkha which would be too numerous to list here.
    • For Mahayana Buddhists, it is realized you are taking the “Bodhisattva vow and path” and that you will be in the cycle of birth and death (rebirth) countless times (kalpas) as you are able to truly follow the path (just like the Buddha did as he was a Bodhisattva countless times until his final birth and death).
    • For Theravada Buddhists, you take the approach of “get out now” (imagine a burning house) and that we need to focus with all our intensity in this life to escape birth and death.  The Buddha gave you the blueprints (so to speak) so you can get free!
    • Regardless of the school of Buddhism, it is recognized that attachments are the root of all Dukkha (suffering), and that is thus the focus.  For humans, it is taught in Buddhism that we are essentially ignorant (oblivious) about what is the cause of Dukkha which is a barrier for us to overcome it.  The major difference is that Mahayana Buddhists believe nobody can truly escape the cycle of birth and death until all are freed (Bodhisattva vow to save all beings), which includes Arhats.  Whereas Theravada Buddhists believe that you can become an Arhat (and be enlightened) and can be freed.

The next step for anyone who really wants to focus on the cessation of Dukkha in their lives is to become a Buddhist and get to practicing!  After all, saying you want to run in a marathon is great, but you won’t get to the finish line if you don’t start practicing (and want to achieve that goal)!

Or to use a more fitting analogy, would you continue walking around with a rock in your shoe that is causing you misery, or would you take off your shoe and get rid of it?  When it comes to Dukkha, we are living in ignorance walking around endlessly with that rock in your shoes (the rock is my analogy for “attachments”).  Make the vow the get rid of it and taking off that shoe might one day be an easy thing to do!

Is It OK to Use the Word “Suffering”?

The Buddha attends to a sick monk.

So, at the beginning of this article, I said it is “OK” to refer to Dukkha as “suffering”.  Why?

The answer is easy and is my own opinion:  because the Dharma must be relatable to everyday people.  And everyday people are not monastics, intellectuals, or theologians.  They have busy lives, and if we alienate them with a foreign-sounding word (no matter how correct that may be to use), they will just move on.  And rightfully so.  I have seen this happen countless times.

While the desire to spread the Dharma correctly and “perfectly” is certainly understandable, and I would prefer to just say “Dukkha” myself, we are far from that luxury, especially in the West.

People need some way to enter Buddhism that is relatable and go from there.  For instance, perhaps someone has always heard “suffering” instead of “Dukkha” and now they are here at this article (or on Access to Insight, Buddhanet, their Dharma teacher, a monastic, etc.) learning more.  Imagine if they were just told “Dukkha” in the beginning (along with a lot of other explanations and definitions that intellectuals and deep practitioners may say), and in frustration, they just said “no thanks” and never thought of Buddhism again except for it being a complex and inaccessible foreign religion.

“Suffering” is actually too extreme a word for Dukkha, but that is the frequent problem with translating it into English words because there can really be no happy medium.  English words would be either too little or too much.

Buddhism is not a religion of exclusivity.  Rather, it is something for every single sentient being on this planet since we all have Buddha-nature, and our true state is Nirvana.  Buddhism is simply the vehicle (teachings, etc.) to help us uncover and realize that.  The teachings (Dharma) is available, and we can further explain and help others understand as they progress and are able to.

We must be skillful, however, to realize if we are going to explain the First Noble Truth to someone (which is, of course, about Dukkha), we need to explain it in a way that relates to them as a starting point.  For some, maybe “suffering” is a good starting point while figuratively emphasizing there is a big asterisk next to that and you can explain more gradually.  For others, it may be something similar to “do you ever feel that things are just ‘off’?”, or others who might be ready for the intellectual point of “dukkha” while also giving them a big asterisk of “there is more to this than the intellectual side!”.

Remember, nobody started out learning advanced calculus without first learning basic addition and subtraction 😉

Article Notes

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